Provider Demographics
NPI:1316563877
Name:HAMILTON, STEPHANIE D (HAIR LOSS SPECIALIST)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:D
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:HAIR LOSS SPECIALIST
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:D
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HEALTH COACH, DNM
Mailing Address - Street 1:37 WILLIS ST S
Mailing Address - Street 2:
Mailing Address - City:YEMASSEE
Mailing Address - State:SC
Mailing Address - Zip Code:29945-2420
Mailing Address - Country:US
Mailing Address - Phone:843-476-6210
Mailing Address - Fax:
Practice Address - Street 1:37 WILLIS ST S
Practice Address - Street 2:
Practice Address - City:YEMASSEE
Practice Address - State:SC
Practice Address - Zip Code:29945-2420
Practice Address - Country:US
Practice Address - Phone:843-476-6210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-21
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC40384301OtherAMERICAN ASS. OF DRUGLESS PRACTITIONERS
SCJZ7AIV25QBOtherSILKOUT PRO
SCUC-07017241-802COtherHERBALISM: PROFESSIONAL